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NCHD Overtime - Newstalk Lunchtime Show

Dr Mark Murphy, Chairman, NCHD Committee was interviewed on the lunchtime show on Newstalk in relation to the overtime worked by NCHDs in Irelands’ hospitals.The following is a transcript of extract from the interview.

PROGRAMME

Newstalk Lunchtime

STATION

Newstalk

SUBJECT

Dr Mark Murphy

DATE/TIME

25.05.2011 - 12.40pm

OUR REF

1105055 – REF: HOC

DURATION

10 Minutes

Damien Kiberd:

Now the whole issue of junior hospital doctors working excess hours has reared its ugly head again, with claims that some doctors are working over one hundred hours per week. I’m joined now by Dr. Mark Murphy, who’s the Chair of the Irish Medical Organisation’s Non-Consultant Hospital Doctors Committee. Dr. Murphy, good afternoon to you.

Now first of all I want you to tell us about your own working experience. Are you working long hours?

Dr. Mark Murphy:

Yes, I’m qualified six to seven years now and over this period I’ve worked around the country in Ireland, I’ve also worked abroad, and within my professional life in Ireland I’ve always worked in excess of sixty-seventy hours in all of the hospital rotations I’ve done. Last week, for example, I would have worked approximately eighty hours, I think eighty-three hours within the week, and this would be a generality amongst all NCHDs in Ireland. Some NCHDs would have worked less, some NCHDs would work far more, even a hundred/a hundred and twenty hours a week and this is unique in the world really. Ireland really hasn’t tackled this problem of excessive working hours which the NCHDs do.

Damien Kiberd:

What countries did you work in before?

Dr. Mark Murphy:

I have worked in New Zealand and I suppose the average working week down there would be in the region of fifty hours and just to kind of think through the logic of that, the health service down there feels that patients, I suppose the quality of care and the health and safety of patients is jeopardised by doctors that work longer hours so they’ve changed their health service around to try to attempt to improve the training of doctors and improve patient care, whereas paradoxically in Ireland we still have a system where we have a health service that’s completely dependent on NCHDs and NCHDs work far in excess of what is legal and what is right yet they’re trained…

Damien Kiberd:

Yes, I want to ask you about that later, but what you say is you did eighty-three hours last week.

Dr. Mark Murphy:

Yes, I did.

Damien Kiberd:

And how do you feel about that, like were you exhausted?

Dr. Mark Murphy:

Yes, well I was exhausted, extremely fatigued, very run down, you know, there are massive social, personal and family sacrifices that go along with working these hours and it does go a long way to explaining the massive disenfranchised and frustrated morale which NCHDs feel at the moment and it’s explaining why NCHDs are voting with their feet and, in fact, leaving Ireland, and it’s these working hours which is one of the factors that will explain the likely manpower crisis that will affect the Irish health service from July.

Damien Kiberd:

Now, Dr. Mark Murphy you said you worked eighty-three hours, there are doctors working a hundred or a hundred and ten or a hundred and twenty hours, is that correct?

Dr. Mark Murphy:

That is correct, yes. I suppose in Ireland there have been some radical proposals to try and bring down these hours that have been offered to successive Governments over the past twenty years, there was the Tierney Report and the Hanley Report, and they recognised that it’s unsustainable for doctors to work a hundred and ten hours a week, and it’s unsustainable for the patients because patient care will suffer, and they’ve recommended radical proposals, such as reforming and reconfiguring the acute hospital services, increasing consultant numbers and increasingly reducing and changing the cultural reliance of NCHDs in Ireland, maybe giving the roles, many of the working roles that NCHDs perform, to other health professionals and improving information technology, and because each of those issues hasn’t been addressed, in 2011 we’re faced with a situation where the system is completely reliant of NCHDs and now because of poor training and a demoralised workforce many of these NCHDs do not want to work in Ireland any more.

Damien Kiberd:

And who is to blame for this?

Dr. Mark Murphy:

I would put the blame at successive Government failures to introduce the unpopular but necessary decisions to improve the health service generally for patient care and for training, so it’s not down to one particular body, but when a Minister sanctions an expert group report, such as the Hanley Report, just like a private enterprise would sanction a consultancy firm to improve the efficiency within that company, it’s incumbent on that Minister to execute that expert group report and when the Tierney Report and Hanley Report were not executed in their full I’d put the blame at the Ministers and the Governments that do not listen to the health policy makers who are trying to..

Damien Kiberd:

Forgive my ignorance but I thought there was a European law in relation to all of this.

Dr. Mark Murphy:

There is, there is a European Working Time Directive which actually came in approximately ten years ago but there was a period of time by which all the EU nations could try and achieve a semblance towards a forty-eight hour working week. In Ireland we have only attempted to try and get European Working Time compliance within the past two years but the future does not look bright in that the way the Irish health service is structured with multiple small acute hospital services, completely reliant on NCHDs, it will be very difficult for an NCHD working a week in a smaller hospital, such as Roscommon, such as Kerry, be very hard for their working week in a small services such as paediatrics or surgery or anaesthetics to get anywhere below seventy/eighty hours unless there is a radical reform of the Irish healthcare…

Damien Kiberd:

Impossible to get below seventy or eighty! There’s a very obvious question Dr. Mark Murphy, are you afraid when you’re doing your job that you’ll make a mistake?

Dr. Mark Murphy:

I could give examples of when my capacity to form appropriate judgements and make appropriate management decisions have been impaired, I would, let’s say in my eighty-three hour working week last week I would have been extremely fatigued and I would have, if I was a service user, a patient, which I am because I’m a taxpayer, I would be complaining to my local TD that the local hospital is staffed by fatigued doctors because evidence has supported that all professionals, from truck drivers to NCHDs, cannot work in a fatigued state and this is why there is European legislation protecting patients but unfortunately it’s not in Ireland because we are unable to get European Working Time compliance.

Damien Kiberd:

The reason I ask you this is I’ve actually myself working in jobs where I’ve had to work for fourteen or fifteen hours a day and I just feel that nobody can carry on beyond that point, you just become so tired that you start to make errors and basic small areas, mostly they don’t matter, they can be corrected or whatever, but there is a danger you could make a big error as well.

Dr. Mark Murphy:

There is, patient safety is paramount and there are documented examples where mistakes have been made because a doctor is extremely fatigued, maybe awake for thirty-six hours in a row and if my mother was being treated by such a doctor I would think that was a disgrace yet it happens every day of the week in Ireland.

Damien Kiberd:

You wouldn’t allow your mother to be put on a trolley say and be treated by a doctor who had worked say eighty hours/ninety hours.

Dr. Mark Murphy:

Well I just don’t think it’s right and ones priority has to be with the patients. I should say a word for the NCHDs, of whom I am their, I am their Chairperson at the moment, NCHDs are this, it affects NCHDs too in terms of their social, personal and family commitments and there are huge personal sacrifices that take place but in terms of road traffic accidents and physical and mental health problems NCHDs are at greater risk than the rest of the population and I think…

Damien Kiberd:

Yes but Dr. Murphy, do you have any life other than your work if you’re working a hundred hours?

Dr. Mark Murphy:

Well Damien I try to but it can be hard, I mean I do enjoy the outdoors rarely and I like to catch up with my friends but ultimately most of my life is spent within the environs of the hospital, eighty hours per week and in my free time I am continuously doing audits, research, exams, to try and make myself an improved and specialist doctor.

Damien Kiberd:

And a final question for you. Are you hopeful that the new Minister will do something about this?

Dr. Mark Murphy:

Well I am, I won’t provide too many platitudes but it is very encouraging that he shares the same ideology structure as most doctors in Ireland in terms of his desire to bring in a universal and more exorable healthcare service and parallel to that being a doctor he remembers, and I’ve spoken to him personally and he’s spoken to the IMO, about his days as a non-consultant hospital doctor and he described them as being a gopher, portering x-rays to and from radiology, portering blood tests with no information technology available.

Damien Kiberd:

What, doing manual work effectively.

Dr. Mark Murphy:

Yes, manual work and the working roles of these doctors in Ireland would be unique in the world, there’s a cultural reliance on these NCHDs and Minister Reilly, I hope that he will stay true to his word and attempt to reform the type of work that NCHDs do parallel to his overall health reforms.

Damien Kiberd:

Okay, listen I wish I could talk for longer to you but Dr. Mark Murphy, Chairman of the IMO’s NCHD Committee, thank you for joining us here on the Lunchtime Programme on Newstalk 106-108.